3D-Slicer联合智能手机辅助定位下神经内镜血肿清除术对基底节区脑出血患者的应用价值研究

3D-Slicer Combined with Smartphone-assisted Positioning of Neuroendoscopic Hematoma Removal in Patients with Cerebral Hemorrhage in the Basal Ganglia Area

目的探讨3D-Slicer联合智能手机辅助定位下神经内镜血肿清除术对基底节区脑出血的应用价值。方法选择2019年9月至2020年12月接诊的82例基底节区脑出血患者为研究对象。以随机数字表法分为对照组(行小骨窗开颅脑内血肿清除术) 41例和观察组(行3D-Slicer联合智能手机辅助定位下神经内镜血肿清除术)41例,比较两组患者手术一般情况、血肿清除率、氧化应激指标、脑损伤相关指标水平、预后及并发症发生情况。结果两组患者性别、年龄、血肿量、发病至手术时间、GCS评分、糖尿病发生率、高脂血症发生率比较,差异均无统计学意义(P>0.05)。两组患者术中出血量、术后住院时间比较(均P>0.05),观察组手术时间较对照组更长(P<0.05)。观察组在术后1 d及3 d血肿清除率均高于对照组(均P<0.05)。术后1周两组MDA水平均低于术前,且观察组低于对照组;术后1周两组SOD、GSH-px水平均高于术前,且观察组均高于对照组(均P<0.05)。术后1周两组S-100β、NSE及GFAP水平均低于术前,且观察组均低于对照组(均P<0.05)。观察组术后6个月预后良好率(5.37%)高于对照组(65.85%)(P<0.05)。对照组出现并发症4例(9.76%),观察组出现并发症3例(7.32%),两组间比较差异无统计学意义(P>0.05)。结论 3D-Slicer联合智能手机辅助定位下神经内镜血肿清除术与小骨窗开颅脑内血肿清除术比较,可提高基底节区脑出血患者血肿清除率、缓解氧化应激反应、降低脑损伤相关指标水平并改善预后。

Aim To explore the application value of 3D-Slicer combined with smartphone-assisted neuroendoscopic hematoma removal in patients with cerebral hemorrhage in the basal ganglia. Methods A total of 82 patients with cerebral hemorrhage in the basal ganglia region who were admitted to our hospital from September 2019 to December 2020 were selected for the study. They were divided into 2 groups by random number table method, 41 cases in each group. The control group underwent small bone window craniotomy to remove intracerebral hematoma, and the observation group underwent 3D-Slicer combined with smartphone-assisted positioning for neuroendoscopic hematoma removal. The general operation conditions, hematoma clearance rate, oxidative stress indicators, neurological factor levels, prognosis and complications of the two groups were compared. Results There was no significant difference in intraoperative blood loss and postoperative hospital stay between the two groups(P>0.05). The operation time of the observation group was longer than that of the control group(P<0.05). The hematoma clearance rate in the observation group on the 1 st and 3 rd day after operation was higher than that of the control group(P<0.05). At one week after operation, the MDA of the two groups of patients was lower than that before operation, and the observation group was lower than the control group. One week after operation, the SOD and GSH-px of the two groups were higher than those before operation, and the observation group was higher than that of the control group(P <0.05). One week after operation, the S-100β, NSE, and GFAP of the two groups were lower than those before operation, and the observation group was lower than the control group(P<0.05). The good prognosis rate of the observation group 6 months after operation was 85.37%, which was higher than 65.85% of the control group(P<0.05). The control group had 4 cases(9.76%) of complications, the observation group had 3 cases(7.32%) of complications, there was no statistically significant difference between the two groups(P>0.05). Conclusion Compared with small bone window craniotomy to remove intracerebral hematoma, 3D-slicer combined with smartphone assisted neuroendoscopic hematoma removal can improve the hematoma removal rate, alleviate oxidative stress, reduce the level of nerve factors and improve the prognosis of patients with basal ganglia intracerebral hemorrhage.